NOTA RETUR

No :
ATAS FAKTUR PAJAK NO :
TANGGAL FP :

PEMBELI BKP/PENERIMA JKP

Nama : PT ANUTA KARYA PRIMA
Alamat : JL. AL KHAIRAT TONDO PALU TIMUR PALU SULAWESI TENGAH - INDONESIA
NPWP : 01.734.816.0-831.000

KEPADA PENJUAL :
Nama : PT SINAR SOSRO
Alamat : JL. RAYA SULTAN AGUNG KM 28 , KOTA BEKASI
NPWP : 01.002.960.1-092.000

NAMA BARANG / JASA KENA PAJAK JUMLAH BRG HARGA

No.
YANG DIKEMBALIKAN DOS PCS DOS PCS
1 CCK 1L GUAVA (12) 13 180,180 15,015
2 CCK 250 ML GUAVA (24) 71 83,784 3,491
3 CCK OE 250 ML FIT FRESH (24) 83 103,153 4,298
4 CCK 1L ORANGE (12) 18 180,180 15,015
5 CCK PG 250 ML FIT FRESH (24) 9 103,153 4,298
6 FTE 500ML APPLE (24) 3 100,450 4,185
7 FTE 350ML BLACKCURRENT (12) 253 33,874 2,823
8 FTE 350ML FREEZE (12) 14 33,874 2,823
9 FTE 500ML FREEZE (24) 12 100,450 4,185
10 FTE 350ML MARKISA (12) 77 33,874 2,823
11 FTE 500ML STRAWBERRY (24) 29 100,450 4,185
12 FTE 350ML STRAWBERRY (12) 49 33,874 2,823
13 FTE 500ML XTREME (24) 6 100,450 4,185
14 FTG 200ML BLACKCURRENT (24) 25 44,955 1,873
15 FTK 250ML APPLE (24) 366 49,099 2,046
16 JAYO 150ML (12) 91 49,099 4,092
17 STEE 390 ML (12) 11 25,495 2,125
18 STK 200ML (24) 1,526 30,180 1,258
19 TBE 350ML ASEPTIC (12) 21 33,874 2,823
20 TBE 350ML ASEPTIC TAWAR (12) 3 33,874 2,823
21 TBK 200ML (24) 165 44,955 1,873
22 TSC 330ML (24) 17 75,225 3,134

Jumlah Harga Jual BKP Yang Dikembalikan

Dikurangi Potongan Harga Yang Dikembalikan
Dasar Pengenaan Pajak Yang Dikembalikan
Pajak Pertambahan Nilai Yang Diminta kembali
 Palu, 15 Agustus 2023
PEMBELI

CHANDRA ANTOLIS

Lembar Ke-1 : Untuk Pengusaha Kena Pajak Yang Menerbitkan Faktur Pajak
Lembar Ke-2 : Untuk Pembeli BKP
 Hal : 1/1

INDONESIA

HARGA BKP YANG

DIKEMBALIKAN
195,195 ITEM HARGA (EX HARGA
PPN) (IN PPN)
247,860 TBS 220 ML (24) 43,694 48,500
356,738 TSB 230 ML (24) 45,045 50,000
270,270 TBK 200ML (24) 44,955 49,900
38,682 TBK 250ML (24) 49,099 54,500
12,556 FTG 200ML APPLE (24) 44,955 49,900
714,174 FTG 200ML BLACKCURRENT (24) 44,955 49,900
39,520 FTG 200ML GUAVA (24) 44,955 49,900
50,225 FTG 200ML STRAWBERRY (24) 44,955 49,900
217,357 FTG 200ML XTREME (24) 44,955 49,900
121,378 FTG 200ML FREEZE (24) 44,955 49,900
138,318 TBK 330 ML (24) 53,243 59,100
25,113 FTO 230ML APPLE (24) 37,838 42,000
46,828 FTO 230ML BLACKCURRENT (24) 37,838 42,000
748,761 CCK 250 ML GUAVA (24) 83,784 93,000
372,335 CCK 250 ML ORANGE (24) 83,784 93,000
23,371 CCK 250 ML APPLE (24) 83,784 93,000
1,918,956 CCK 250 ML MANGO (24) 83,784 93,000
59,279 CCK 1L GUAVA (12) 180,180 200,000
8,468 CCK 1L MANGO (12) 180,180 200,000
309,065 CCK 1L APPLE (12) 180,180 200,000
53,285 CCK 1L ORANGE (12) 180,180 200,000
TBK 1L (12) 77,477 86,000
TBE 450 ML LS (24) 100,450 111,500
5,967,736 TBE 450 ML (24) 100,450 111,500
FTE 500ML FREEZE (24) 100,450 111,500
5,967,736 FTE 500ML BLACKCURRENT (24) 100,450 111,500
656,451 FTE 500ML GUAVA (24) 100,450 111,500
 FTE 500ML APPLE (24) 100,450 111,500
FTE 500ML XTREME (24) 100,450 111,500
FTE 500ML LEMON (24) 100,450 111,500
FTE 500ML STRAWBERRY (24) 100,450 111,500
TSE 500ML (24) 117,117 130,000
STEE 350 ML (12) 25,495 28,300
FTC 318ML APPLE (24) 72,072 80,000
FTC 318ML BLACKCURRENT (24) 72,072 80,000
FTC 318ML FREEZE (24) 72,072 80,000
TBN 318 72,072 80,000
6,624,188 TBE 350ML ASEPTIC (12) 33,874 37,600
TBE 350ML ASEPTIC TAWAR (12) 33,874 37,600
FTE 350ML APPLE (12) 33,874 37,600
FTE 350ML BLACKCURRENT (12) 33,874 37,600
FTE 350ML LEMON (12) 33,874 37,600
FTE 350ML GUAVA (12) 33,874 37,600
FTE 350ML FREEZE (12) 33,874 37,600
FTE 350ML MARKISA (12) 33,874 37,600
FTE 350ML STRAWBERRY (12) 33,874 37,600
TSC 330ML (24) 75,225 83,500
PAB 330ML (24) 27,027 30,000
PAB 600ML (24) 32,432 36,000
PAB 1500ML (12) 36,036 40,000
STK 200ML (24) 30,180 33,500
TBK 250ML S6 (24) 49,099 54,500
TBK 250ML LS (24) 49,099 54,500
JAYO 150ML (12) 49,099 54,500
TBK 200ML S6(24) 44,955 49,900
STEE 390 ML (12) 25,495 28,300
CCK GD 250 ML FIT FRESH (24) 103,153 114,500
CCK PG 250 ML FIT FRESH (24) 103,153 114,500
CCK OE 250 ML FIT FRESH (24) 103,153 114,500
TSE SPARKLING LL 300ML (12) 33,874 37600
FTK 250ML BLACKCURRENT (24) 49,099 54500
FTK 250ML APPLE (24) 49,099 54500
FTK 250ML LEMON (24) 49,099 54500
FTE 500ML MARKISA (24) 100450.45 111500
FTE 350ML COCOPANDAN(12) 33,874 37,600
 ITEM HARGA (EX PPN)
TBS 220 ML (24) 1,821
TSB 230 ML (24) 1,877
TBK 200ML (24) 1,873
TBK 250ML (24) 2,046
FTG 200ML APPLE (24) 1,873
FTG 200ML BLACKCURRENT (24) 1,873
FTG 200ML GUAVA (24) 1,873
FTG 200ML STRAWBERRY (24) 1,873
FTG 200ML XTREME (24) 1,873
FTG 200ML FREEZE (24) 1,873
TBK 330 ML (24) 2,218
FTO 230ML APPLE (24) 1,577
FTO 230ML BLACKCURRENT (24) 1,577
CCK 250 ML GUAVA (24) 3,491
CCK 250 ML ORANGE (24) 3,491
CCK 250 ML APPLE (24) 3,491
CCK 250 ML MANGO (24) 3,491
CCK 1L GUAVA (12) 15,015
CCK 1L MANGO (12) 15,015
CCK 1L APPLE (12) 15,015
CCK 1L ORANGE (12) 15,015
TBK 1L (12) 6,456
TBE 450 ML LS (24) 4,185
TBE 450 ML (24) 4,185
FTE 500ML FREEZE (24) 4,185
FTE 500ML BLACKCURRENT (24) 4,185
FTE 500ML GUAVA (24) 4,185
FTE 500ML APPLE (24) 4,185
FTE 500ML XTREME (24) 4,185
FTE 500ML LEMON (24) 4,185
FTE 500ML STRAWBERRY (24) 4,185
TSE 500ML (24) 4,880
STEE 350 ML (12) 2,125
FTC 318ML APPLE (24) 3,003
FTC 318ML BLACKCURRENT (24) 3,003
FTC 318ML FREEZE (24) 3,003
TBN 3,003
TBE 350ML ASEPTIC (12) 2,823
TBE 350ML ASEPTIC TAWAR (12) 2,823
FTE 350ML APPLE (12) 2,823
FTE 350ML BLACKCURRENT (12) 2,823
FTE 350ML LEMON (12) 2,823
FTE 350ML GUAVA (12) 2,823
FTE 350ML FREEZE (12) 2,823
FTE 350ML MARKISA (12) 2,823
FTE 350ML STRAWBERRY (12) 2,823
TSC 330ML (24) 3,134
PAB 330ML (24) 1,126
PAB 600ML (24) 1,351
PAB 1500ML (12) 3,003
STK 200ML (24) 1,258
TBK 250ML S6 (24) 2,046
TBK 250ML LS (24) 2,046
JAYO 150ML (12) 4,092
TBK 200ML S6(24) 1,873
STEE 390 ML (12) 2,125
CCK GD 250 ML FIT FRESH (24) 4,298.05
CCK PG 250 ML FIT FRESH (24) 4,298.05
CCK OE 250 ML FIT FRESH (24) 4,298.05
TSE SPARKLING LL 300ML (12) 2,823
FTK 250ML BLACKCURRENT (24) 2,046
FTK 250ML APPLE (24) 2,046
FTK 250ML LEMON (24) 2,046
FTE 500ML MARKISA (24)
FTE 350ML COCOPANDAN(12) 2,823
 NOTA RETUR
Hal : 1/2
No :
ATAS FAKTUR PAJAK NO :
TANGGAL FP :
KET :

PEMBELI BKP/PENERIMA JKP

Nama : PT ANUTA KARYA PRIMA
Alamat : JL. AL KHAIRAT TONDO PALU TIMUR PALU SULAWESI TENGAH - INDONESIA
NPWP : 01.734.816.0-831.000

KEPADA PENJUAL :
Nama : PT SINAR SOSRO
Alamat : JL. RAYA SULTAN AGUNG KM 28 , KOTA BEKASI
NPWP : 01.002.960.1-092.000

NAMA BARANG / JASA KENA PAJAK JUMLAH BARANG HARGA HARGA BKP YANG
No.
YANG DIKEMBALIKAN DOS PCS DOS PCS DIKEMBALIKAN

1 CCK GD 250 ML FIT FRESH (24) 31 103,153 4,298 133,238

2 CCK 1L MANGO (12) 21 180,180 15,015 315,315
3 CCK OE 250 ML FIT FRESH (24) 48 103,153 4,298 206,304
4 CCK 1L ORANGE (12) 16 180,180 15,015 240,240
5 FTE 500ML APPLE (24) 1 100,450 4,185 4,185
6 FTE 350ML APPLE (12) 101 33,874 2,822 285,052
7 FTE 500ML BLACKCURRENT (24) 1 100,450 4,185 4,185
8 FTE 350ML FREEZE (12) 50 33,874 2,822 141,115
9 FTE 500ML FREEZE (24) 29 100,450 4,185 121,365
10 FTE 350ML LEMON (12) 147 33,874 2,822 414,834
11 FTE 350ML MARKISA (12) 41 33,874 2,822 115,720
12 FTE 500ML STRAWBERRY (24) 9 100,450 4,185 37,665
13 FTE 350ML STRAWBERRY (12) 76 33,874 2,822 214,495
14 FTE 500ML XTREME (24) 42 100,450 4,185 175,770
15 FTG 200ML FREEZE (24) 47 44,955 1,873 88,031
16 FTG 200ML STRAWBERRY (24) 49 44,955 1,873 91,777
17 FTK 250ML APPLE (24) 154 49,099 2,046 315,038
18 FTK 250ML BLACKCURRENT (24) 29 49,099 2,046 59,325
19 FTO 230ML APPLE (24) 4 40,000 1,667 6,666
20 JAYO 150ML (12) 50 49,099 4,092 204,575
21 STEE 390 ML (12) 6 25,495 2,125 12,748
22 STK 200ML (24) 299 30,180 1,258 375,993

Jumlah Harga Jual BKP Yang Dikembalikan 3,563,636

Dikurangi Potongan Harga Yang Dikembalikan
Dasar Pengenaan Pajak Yang Dikembalikan
Pajak Pertambahan Nilai Yang Diminta kembali

Palu, 19 Mei 2023

PEMBELI

CHANDRA ANTOLIS

Lembar Ke-1 : Untuk Pengusaha Kena Pajak Yang Menerbitkan Faktur Pajak
Lembar Ke-2 : Untuk Pembeli BKP